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Furthermore, Haifa University public health lecturer Itzhak Zaidise said, there is a widespread feeling that the medical infrastructure, as distinct from the care, is “lousy.” More beds and staff are needed urgently, he said. Zaidise believes that even after additional expenditures to address this, the Israeli system would still be far more cost-effective than that in the United States. With just an extra 1% of the GDP, the Israeli health system could “solve all the problems,” he said.
The Israeli system is also not immune to charges of inequality. The HMOs offer an extra tier of insurance for those who can pay, which typically costs about $50 a month for a family of four. It’s a premium purchased by all but 20% of the population, these being mostly the poorest.
People with supplementary insurance are allowed to select their doctor for certain consultations and have access to extra afternoon and evening clinics that others do not. They thereby tend to secure appointments more quickly, and some of the best-regarded doctors become so in demand by those with supplementary insurance that others find it hard to see them. Supplementary insurance also provides access to some medicines not included in the health basket.
“My concern is that we are moving towards a two-tier system that will determine access to health based on how much you can pay,” said Ono Academic College researcher Amir Paz-Fuchs, one of Israel’s leading scholars on inequality. Paz-Fuchs is the former head of the Center for the Rights of the Unemployed.
Ehud Kokia, director general of Hadassah Medical Organization, which runs some of Israel’s largest and most prestigious hospitals, also sees trouble ahead. “The system is underfunded, and the only way to fix it is by having the government add more money,” he said. Health care funding needs to fight for its place on the government agenda against other urgent needs such as security and defense, he said.
Stav Shaffir, one of the leaders of Israel’s social protest movement, said one of the protest movement’s demands in this summer’s demonstrations is that “we get our health care system back.” She stated that otherwise, they are “afraid that the Israeli system of health care will become the American system.”